"That is happiness; to be disolved into something complete and great. When it comes to one, it comes as naturally as sleep." - Willa Cather

There was an error in this gadget

Monday, 20 February 2012

Exercise in health and dishealth

Here are some statements from Captain Obvious (me):

1. Just because you exercise, does not mean you are healthy2. Though I may be in relatively good shape physically, no one reading this blog should look at me as a model of good psychiatric health.

The other day, I received an email from a Russian woman living in Israel who thanked me for the inspiration to keep running while pregnant. She had what sounded like a healthy and happy pregnancy experience followed by a home birth of her beautiful baby boy. The boy's name means "lion of God" in Hebrew. Anyone know what that name is? I hope other women in Israel have been inspired by her. And if anyone reading this blog wants a good resource for how to use your mind to overcome the pain of childbirth, I can put you in touch with her.

I have been happy to be able to reassure women that exercise in pregnancy is healthy. And that women have better pregnancies and babies have better outcomes because of it. But I also owe it to the readers of this blog to point out that, heck, I am not someone who is to be modelled when it comes to exercise habits! I exercise to stay sane and thus exercise way too much, when I have the time, and rarely train right. But yeah, you can run 6 marathons while pregnant, enjoy it and know it isn't dangerous.

I'm getting to the point. Don't worry. I have shown this post to SR and my sister already and it is a big deal for me to come out with this.

I have many times alluded to my Obsessive Compulsive Disorder and that is something I am comfortable with because I have come to terms with it and actually have greatly improved my symptoms simply by becoming educated about the condition. And the fact that I have battled with anorexia has also come up often. It is an enemy I know well and will most likely fight it my entire life (my current BMI of 17.3 does not speak to my condition being under control).

But during approximately the entire month of January, I was even further from normal. It seems many of you could detect it despite my not writing about it directly. I didn't know how to write about it, because I didn't know what it was. Though, looking back, the words "crazy", "depressed" "lonely" and "manic" all came up.

It has happened four times now. A period of about a month where I can't sleep; I am restless, short-tempered, obnoxious to be around and riddled with anxiety and guilt which cycle viciously inside of me. I had told SR when we started dating now 5 years ago that I had just had a manic episode (that one worked out well because I was on trauma surgery and when I walked home from work I could sit in SR's back yard and dream about knocking on his door in the middle of the night). But I hadn't had one since. And I didn't even know that's what it was until it was over (despite being confronted by more than one immediate family member about getting psychiatric help - and I wanted it desperately). And then sometime around last Thursday (10 days ago), it started to end. And I was somehow breathing more normally and thinking clearly.

It is such a gift to be calm again. I am ashamed to go into details about our trip to Mammoth Lakes and that is why I didn't write much about it at the time. As my sister, who was along, described, the dark circles under my eyes just kept getting darker. I would wake up hours before everyone and sit there with my coffee, shaking and with tears in my crazy eyes waiting for everyone to wake up, for someone to say they would watch the kids while I went for a run. I only got myself to ski one run (skiing was just too relaxing for me, I guess). I was so focused on running every available minute of babysitting time. I even stayed up nearly all night one night while SR watched the kids and I ran on icy mountain trails in the moonlight. I didn't want the rest of my family knowing that I needed to run nearly a marathon the same night that I had run a marathon during the day...

And what on earth? I have no idea now how I ran a 3:14 marathon on the treadmill two days after running a 20 mile PR on the treadmill and then two days later running a 20 mile tempo again. I would lay awake in bed envisioning running an actual marathon and I thought if someone simply showed me a starting line, I could finish in less than 3 hours. As of today, I have absolutely no clue how I could have thought that. Many of you probably thought I was lying about those running times, but I wasn't.

And the shear stupidity of buying plane tickets to run a marathon in New Orleans without my family! What was I thinking? I remember not being able to tell SR that I bought them, feeling like a thief in the night. Well, I'm not going. I wasted a ton of money and I regret it enormously. (We are now running a 5k together that weekend in La Crosse to raise money for the Special Olympics). How could I forget my love of trails, local races and running with my husband?

Ok. I could easily write a novel about the now four manic and two or three depressed episodes (the depressed episodes are not as clearly delineated for me as the manic ones) I have had, but I think you all know enough to get my point.

I do realize that writing this is not a great strategic career move. And it doesn't make me appear to have things under control. But I am okay with that. I often wonder if the mental health of ultra runners is a bit of a neglected topic. Rather than going into tons of details right now, I would just like to open things up for discussion. Whatever comes into your head is okay.

I am in such a good mood these days that I can take any sort of accusations. Bring them on. Just having my "old self" back again is something that makes me incredibly thankful. I can't help thinking of the meaning of the name Mattias, "gift of God".

No, I am not saying I am suddenly "normal", I am only saying, I feel good in my skin once again.

After taking two days of running just 1 mile. Not 1 times 10, just 1, I was ready for some good running again. Here I am after a 21 miler, modeling my new compression tubes fron Compressport, which I am testing for Ultrarun.com. I really like them. (sorry, but I don't think I look like a woman with a BMI of 17.3 Or do I also have body dysmorphic disorder?). Oh, and now you know our address. Or at least the number :).

The running song of the day was inspired by my favorite moment at the Grammy awards (I really knew I wasn't manic anymore when I sat down and watched almost the entire thing with Christian and El Guapo):

The Beach Boys, clearly older than they used to be, walk out on stage and begin playing "Good Vibrations", the cameras almost seems to avoid Brian Wilson but then focus in on his empty, sort of stone-crazy, eyes. Everyone at home must have shifted uncomforably. But out of him comes the most beautiful "I. I love the colorful clothes you wear.." and the world breathed a happy sigh of relief.

Here is an HD recording from the early days:

There are so many things I could say about this amazing song, but I'll keep it to1. electro-theremin2. perfect bridge3. fun running song

67 comments:

kathleen
said...

I was actually wondering today, while on my run, if you were going through some sort of manic phase. Yes, I think about others' lives while running. Now, if I could just figure out my own life while running.

Do you think you are bipolar? Do you thinkhave you areto addicted to running? Are you going to get help? It seems as though when things are good people tend to not want to get help anymore because you know, things are good.

I think it's worth looking into even if it's just a counselor/social works. Someone to give you an outside point of view.

As far as your body goes, you look fine. But telling you that is not going to fix how you see yourself.

SLG - i don't know what to say, I think it is wonderfully brave of you to write this post. i guess I do wonder if post-pardum played into this last episode at all. perhaps now, while you are feeling more sane, is the best time to seek some help and get ahead of this before the next episode. bi-polar or just anxiety disorder are very treatable... regardless i send you a large, warm, bumpy hug and i hope you continue to feel well and be well (and maybe.. sorry to nag... put on just a little bit of weight, you do look terribly thin in your photos).

Ah SLG, phew - you ARE human! (jokes). I was wondering the same as Piccola re PPD/hormone shift as a possibility, but you sure did have a heck of a lot of things going on in your life the past month (or two) which wouldn't have helped. It's great that you DO have an outlet, even if it is running - but I guess even more important then to feed yourself good food (nutrient dense)...personally I think you look very very slim, upping that BMI a bit wouldn't hurt (might make you stronger!) but you don't quite look "unhealthy", not quite. If there are manic periods - like Kathleen and Piccola said - there are ways to help - even if it's training yourself with new thought processes (a very normal but Type A friend of mine attends an anxiety group once a week and is learning some useful tricks to help her)....you are a strong, multi-talented woman but everyone has their own weakness, I guess the more you learn about it and understand it, the lesser that weakness will become. Love that you have SR to watch you through it and be there for you.

"I often wonder if the mental health of ultra runners is a bit of a neglected topic."

Normally I wouldn't comment, but you did ask for it. :)

I agree. I see a lot of ultra-runners and cyclists who are battling their demons on the race course. A lot of recovering alcoholics, folks who deal with depression, and so on. I think a book could and should be written on the topic.

As a sometime ultra-runner I use running as my medication. I know that if I'm not feeling right I need to get out and exercise. Usually an hour does it for me and unlike yourself I find it hard to get out the door and get started.

The mania thing reminds me of Graeme Obree the Scottish cyclist. A great athlete, but not a model of mental health. Mania is a scary thing from the outside, I'm sure you know. I'm glad you're back.

Oh honey. I'm so glad to read this, not because I'm happy that you've been going through this, but because it represents a level of self-honesty that I've never seen you display before.

You know what's going on. You've had a lot of major life changes recently, and for someone who is susceptible to OCD/mania/anorexia, it's almost inevitable that something like that will happen. I hope that you get whatever help you need to get better-even if that is just writing this post.

This post really floored me. You obviously have some awareness regarding what is going on, but like some other commenters, I think seeking counseling could be extremely helpful. Hormones/ life changes seem to have triggered your thoughts/feelings/behaviors and therapy could really help you get ahead of these things next time before deterioration. It is fascinating how mental instability can yield some seemingly positive results i.e. your outstanding race times which then become easy to focus on and spin as a good thing. I don't mean this to sound critical at all, but you seem like the kind of person to try to figure it out yourself because you are very intelligent and could easily "figure out" what's wrong , how to fix it, etc. But I hope you will let someone else guide you and support you. Take care of yourself.

First a disclaimer: I know zip about running ultras and psychiatry, so please take my first comments with a pinch of salt (as Danes say).

It sounds to me as if you’re “self-medicating” doing exercise as others might do drugs or alcohol to adjust the levels of dopamine and serotonin in their brain. While I have no doubt that running is no-end better for you and your family than some of the alternatives there might be even better techniques that can help you cope with the manic and not so manic periods. Waking up in the dark desperate for a run could interfere negatively with other aspects of your life.

I agree with PPC that it’s probably less difficult to learn some of these techniques (cognitive therapy?) when you’re not in acute need of them.

I think you look very thin but not unhealthy in the picture, but SR is probably in a better position to judge that.

In addition (no salt required here), if a future employer stumbles across this post and does not find this level of self-insight and honesty admirerable and highly hire-worthy she needs new spectates.

Thank you for sharing and clarifying what you've only alluded to in posts over the last few months. Although mental health issues have lost much of their stigma over the last few decades, I still think they need to be talked about more. If you were experiencing a physical ailment, it would be normal to discuss it, so why shouldn't a mental health issue be the same? I agree with previous comments that now is a good time to seek out professional help and advice. I certainly am not qualified to weigh in on a diagnosis/treatment, but I can be a concerned reader who would love for you to be able to find balance in your life. I'm glad your manic episode is over and you're feeling better. A BMI of 17.5? You know how I feel about measurements like BMI and weight--for the most part they are useless--but my goodness that's a low number. Take care of yourself!

Oh, and since you asked what the Hebrew name is...I really like the name Ariel.

I think you need friends who are more radical in telling you how destrucitve your behaviour is! Who don´t tell you that you still look healthy (because you think that when you look healthy than your weight is still too high, right?!). You are right in the middle of destroying yourself. Probably you need to stop taking part in ANY EBDURANCE EXERCISE WHATSOEVER for some time, just like an alcoholic you cannot continue to drink some. But the thought to give up the high that excessive calorie-burning gives you is horrifying, right? Get yourself some help, you are too deep into it to solve it on your own!

Since I speak Hebrew fluently, I can only agree with Dina that Ariel is a beautiful name!SLG, you are so brave and I know what it takes to write what you did. Unfortunately I also know that eating disorders are our companions for life. We just have to know how to handle them. The question is, can you right now? And what will you do about it? SR is there for you, but there are also two little boys who need their mom...Take care and this time I have to send you a hug!

I absolutely love your blog and your honesty. You know many of your readers have wondered at times about the choices you made. I think this post explains things really well. There is a literature out there on running and mood disorders and addictions; I think some of the best ultra runners have some sort of psychological issue, and they are coping via exercise. I don't think that is necessarily a bad thing, but you have to keep an eye on it. I certainly know that I would be anxious and depressed without exercise.

I don't think you look like a woman with a 17.3 BMI. But, it is not about the weight. You have the behaviors and the mental demons. You are in a lot of pain and not happy. I think seeking help from a psychologist who understands runners would be really helpful long term. You have a lot of potential as a runner but also as a writer and doctor and mother. This all can go away. People in our lives sometimes lose patience..

Good luck with all of these! Don't let it get to the back of your mind!

You are brave to be so open and write this post, putting everything out there in public. I too like others wonder if there is a post-partum component to this. Besides that you are going through a lot of big changes with moving, the kids, job, etc. Please take care of yourself and get help if you need it, I think this was a first big step. I know from experience with an ED amongst other things that getting it all out there is a huge step and makes you feel like a weight is lifted.

I don't think you look overly thin, but it isn't about weight it is more about being and feeling healthy.

What you got is a no-brainer. What keeps you progressing is SR kind of liking it and supporting it - he said it in no certain terms that he likes your exercise obsession, your thinness and your OCD. Whether or not you want to change it is a whole different deal. Make a decision and stick with it with all your OCD. Until then, it's only wasting words, even if so many like your openness and honesty and self-beating.p.s. I am not sure about your liking 10 mpm pace either, honey:) I see you blasting sub-8's on long runs and sub-6's on mile repeats!

btw, what I also meant is that if it works for you two, and the whole family, it's nobody's business and therefore doesn't "require fixing", and unless the family that you are decide that it is destructive, none of us shall tell you what to do and how to deal with it.

Hey SLG, so glad you're out of that phase and able to recognize the problem! It sounds like a lot of things came together at once to make the last month especially grueling: moving, possible postpartum hormone issues, dead of winter, SR gone a lot . . .

Several people already said now is probably the best time to work on some coping mechanisms to get you through these episodes. I agree!! It's great that SR is there to support you and I'm sure you guys will find a way to get you happy and healthy again.

I am reading all of these comments, often multiple times. It is hard for me to believe how generous you all can be with your time and advice and thoughts. Hearing what you guys have to say is amazingly helpful. I am not saying it substitutes for, you know, professional help. But it is clear to me that you guys have really read what I wrote and that you have constructive ideas.

I also should have mentioned that we have no health insurance in America, so seeing "a professional" is not a very affordable option at this moment. The beauty of the American healthcare system!

SLG - if counseling is something you wish to pursue, many, many clinics and centers offer sliding scale fee services and sometimes even free. I work in the field and another option is if there is a university nearby with a training school you can access services that way. Support groups vs. Individual work is also much more affordable although sometimes more intimidating. Good luck finding what works for you.

I remember distinctly going through a dark period 7 months after my first baby, and 5 months after my second. I believe that postpartum junk (especially if bfeeding is involved?) can sneak on up on a person long after the critical first few weeks. That dark period after my second is proving to be a real turning point for me... hopefully yours will be the same.

I think it is actually very, very common for anorexics to swap classic restriction for obsessive exercise. I did, my thinking remained highly disordered, but i got so much societal feedback for being "healthy" and fit. It was much, much harder to overcome the exercise obsession.

I am largely recovered from my ED, as much as you can be. But in times of stress i still tend to restrict; you've experienced mega stress that probably triggered this episode. When you look back at the periods when you experienced mania do you see a pattern if change or stress precipitating the episode?

I think that it is perfectly ok for you to use lots of running to cope. That's your thing. However, i think that (i am a working wife and mother too, I am not trying to be judge-y, just talking like a girlfriend would) you need to go through a checklist every week or so; am i present in my life? As a mother? Am i really here, being a partner, a wife, a mother, enjoying and participating in their fleeting childhoods? Or am I always chomping at the bit to get away, out the door, back to running? If it is the latter it's not ok. I truly believe that running can absolutely make us better people, wives, mothers. But when it becomes a beast that robs us from our spouses and children it is not healthy.

I think calorie depravation alone feeds mental dishealth. It is almost impossible to feel even when chronically underfed. It also makes it hard to sleep.

Anyhow, I am sorry to hear you have been struggling. It has been a big transition and it is understandable that you would be triggered. I think you owe it to yourself to find a therapist or doc to help you even though you don't have insurance right now.

I can either write volumes on the subject or be pithy... so, be good to youself and just completely ignore numbers for a while: no mileage or times, no weight, no counting how many times various things happen. Enjoy the moment.

SLG, I commend you for your honesty. I, like many others, had wondered if an ED played a part in your life, and I am so happy you have addressed it. I bet many of your readers can relate. I certainly can as I struggle with some of the same demons. I won't comment on how you look in the pictures... there will be no right answer! If I say you like healthy, you will think I mean fat and if I say you are looking thin then you will secretly be happy. At least that's how my mind works... As someone else mentioned, I think these ED's will be a part of us forever and we have to learn how to manage them. You have two beautiful children, and they will be a wonderful reminder of how important it is for you to stay healthy. Once you feel your OCD take over and exercise etc. get in the way of being present with them, then you will know that you have to do make some changes. I think you are on the right path... hang in there. You are a strong woman, a great mother and you clearly have many special gifts and talents. Take it easy on yourself and treat yourself with the same love and consideration you do your family. Lots of hugs from a Dane in America

SLR - you need to move to MA where everyone is covered under Masshealth. I train interns and post docs in the Psych program at MGH - high quality people you could see. I wonder if other states have something similar to Masshealth. You can try universities with psych graduate program as well. Also, you can search this sitehttp://www.abct.org/Members/?m=FindTherapist&fa=FT_Form&nolm=1 which has experts in Cognitive Behavioral Therapy which is the evidenced based treatment for what you describe. Many have sliding fees. Good luck!

"Good Vibrations" is one of my all-time favorite BB songs. That and "God Only Knows" (misplaced modifier and all).

It's a good choice for this post because Brian Wilson essentially went nuts while the BB were trying to make this album because all of those sounds you hear on the vinyl (it used to be vinyl, back in the day - FYI for you whippersnappers) were in his head and he was having a hard time getting them realized in a way he found acceptable. That's why the album, which was supposed to be called Smile, came out as Smiley Smile in 1967 - because the album wasn't good enough or complete enough to be the Smile Brian had in his mind's eye, but the BB had to release something because, hey, it's always about the money after all, isn't it? Can't move product if you gotz no product to move.

Nearly forty years later, Brian alone would record Smile, which, as you might suspect, sounds about 40 years out of date. Nice artifact to have, I guess, but not as essential as it would have been had he finished it in 1967. (Incidentally, on "GV", he reverted back to the original lyrics - some of which Mike Love changed in '66 - so in the opening couplet, e.g., you get: "Ah! I love the colorful clothes she wears/ And she's already working on my brain" instead of "... And the way the sunlight plays upon her hair" ... which is really unfortunate because, hey, I'm no big Mike Love fan (he could be a real dick), but the Love lyrics are without exception superior to the "original" lyrics Brian reverted to in his 2004 re-recording. (Although "working on my brain" seems far more revealing for a guy who was kinda on the edge of sanity at the time of the original recording. Plus: Brain/Brian? Go to town on that, Dr. Freud! But not too far into town, because ... Brian didn't write the original lyrics - Tony Asher did. Brian's genius was that distinctive, layered, multi-harmonied sound.)

All that said, I'm glad to hear you yourself are in a more harmonious state of mind yourself. I myself have given up on trying to understand what motivates ultra-runners in general. It may be some sort of insanity, but for all I know that type of "insanity" may be what keeps any remarkable person, athlete or otherwise, going and one person's perseverance is probably why we have many of the things we value in life, like fire, vaccines and good beer.

Also, who among us is really sane in any meaningful sense? (You will note I'm not raising my hand, and if SteveQ stops by here again, he damn well better not raise his, because I got a shit-ton more sanity to me than he does.)

"It's always something. If they don't make fun of me for my weight, then it's my mental status." - John Goodman, playing "Madman" in a Coen Brothers movie whose name I can't think of just now.

And even that character was more sane than I am. I gots levels of crazy in reserve you ain't even imagined! Now time for me to stand in a sandbox, just like in "Brian Wilson" by Barenaked Ladies, if not real life.

@Kathleen, I am touched you were thinking of me AND wondering if I was in a manic phase. You are not the only one who ponders other blog runners while out on your runs. We all have a special connection to each other. As for the rest, thank you. Answers will come out in future posts, I am certain.

@Matt, thank you for taking the time to comment. Heck, we're ARE all crazy to a certain extent, there are just times when we NEED to admit, yeah, this has gone too far. :) Sounds like Graeme (cool name) must be an example of that. I appreciate your input.

@Diana - mental health illnesses will always be viewed differently than, say, cancers, because they are an integral part of our personality and there will always be a lot of guilt and blame mixed up in them, whether or not this should be the case. I mean, a person always has SOME degree of control over their actions and can thus never completely use a mental diagnosis as an excuse. It is a really complicated subejct.

Well, thank you so much for the compliments. I am glad that my explaining a bit of background put "my choices" as you said into perpective. I follow your blog as well and I am really impressed with how fast you have gotten and would love to know all your secrets. Anyway - lots of thanks and respect to you!

I haven't been reading your blog very long but I wanted to chime in anyways and say that I am another runner who ponders others' blogs while out running and I was wondering what was going on with you. Thank you so much for your honesty and your post. It gave me a lot to think about!

Marathon mom, when you have posted your weight I remember thinking it sounded too light, but you look so good and healthy. Either we are both crazy or we just need to ignore scales and bmi's. You may have a point with post-partum hormones.

Hi there Sea Legs! I haven't read your blog in so long! I'm glad you are cycling back to normal. I can relate. I went on bipolar meds for the first time this year, and it has totally changed my life in a positive way - the smallest dose of Depakote made me a normal human being. Amazing. Running's not going so well for me, though! Trying to fight the fatigue and get back into fighting shape for the season.

Thanks for bringing that up. As a physician I should of course know these things well. But I don't. I am surprised how hard it is to find someone appropriate to see. As for the sliding scale, it just won't help us too much since SR and I make too much combined to ever qualify for a discount, but paying rents in to countries not to mention all the travels back in forth does not mean we have the money to pay!

Danni, I have definitely noticed a correlation between weight loss and the start of "episodes", but for some reason that never stops me from wanting to lose weight. But then again, the pattern is a lot clearer now that it has happened again.

Steve, I really like the "no counting how many times various things happen". I wish someone had told me that as a child(thankfully as an adult, it has been much less of a problem) . Makes me think you must have some experience with OCD - either yourself or someone close. I ran today with no Garmin, just fyi.

Hcarlozzi. Thank you so much for your honesty and yes, I can tell you can relate. Love your comment about how I look. I am always happy to know Danes in the US, too! How weird is it that yesterday two people in La Crosse, WI came up to me speaking Danish? Gosh, Danes sure know how to see the world.

@Ana-Maria, I went to the website and could not find a single provider in MN or WI that treated anything close to what I do or might have. And it actually didn't look like they had any providers from these two states listed at all. Must be more of an East Coast thing, but what a great database idea! Thank you for your time and thoughts!

Hi SLG,Long time reader, first time commenter. I'm also a fellow runner and work in the mental health field, having a fair bit of experience with individuals with anorexia. I admire your bravery and honesty in this post, and wanted to just point out that many of the psychological difficulties you describe experiencing - OCD/obsessive exercise, depression, even "manic" symptoms such as sleeplessness, agitation, etc, are highly correlated with being at a sub-optimal body weight, and in a physiological state of starvation. As a scientist, you might be very interested in reading more about the "Minnesota Starvation Experiment," conducted by Ancel Keys at the University of Minnesota during WWII. I wouldn't normally provide Wikipedia as a reference, but this gives a good overview and lists many of the more relevant scientific publications: http://en.wikipedia.org/wiki/Minnesota_Starvation_Experiment Basically, this demonstrated that previously healthy men who are not getting appropriate calories will develop all of the psychological symptoms you are describing, as well as develop an increased and obsessive need to exercise in some cases. (Recent ED research shows a very strong link between malnutrition and excessive exercise, where the drive to exercise actually *increases* as body weight decreases.) It's also important to remember that what really influences these associated difficulties is whether you are at a sub-optimal body weight/caloric intake for YOU - not whether you are at any particular BMI or percentile. Extremely overweight individuals who rapidly lose weight can develop all of the classic symptoms of anorexia even when at a perfectly normal or "overweight" BMI - I believe the DSMV is likely to modify the current criteria for anorexia nervosa to reflect this reality (or at least it's being discussed). Particularly if you are seeing this mania and other sxs correlated with periods of weight loss for you, I would consider the hypothesis that this is all malnutrition related, and attempt to address this first.

Hope all this is somewhat helpful to you - it just jumped out at me, so I wanted to share. I second or third some of the other commenters too that a great way to get quality psychological services is through training programs at universities and university hospitals - they are most likely to be providing the latest evidence-based treatments, and training clinics typically offer a sliding scale regardless of income. UW-Madison definitely has a clinical psych program, I'm not sure about the university where you are? Or maybe you could even start with a nutritionist with experience in eating disorders if that is most affordable/accessible?

Good luck to you! I hope you can continue to make progress for your beautiful family. Establishing healthy habits now is the best way to ensure that your boys don't struggle with similar issues when they are adults. Sending lots of good thoughts your way!

Seems I'm late to this comment party, so I'm not sure what I could add that hasn't already been said, so I will just say hugs to you and take care of yourself. I agree with those who have advised seeking some form of counseling/therapy even if not covered by insurance.

I think it took a ton of courage for you to write this post. I hope you find the answers and help you need. I enjoy following your blog, and think this was a brutally honest, wonderful post. And a lot to think about, for many of us.

I stumbled upon your blog since I just found out that I was pregnant and needed some assurance that I could run during my pregnancy. I appreciate your honesty and the fact that you admitted that you have some OCD issues. I went into treatment three years ago for anorexia and an exercise obsession. I hit rock bottom and realized that my priorities were all screwed up. I put starving and running way above my husband and daughter. One thing they emphasized in treatment was that relationships are the most important and meaningful part of your life. To be honest, running never really gives me the same kind of joy that my family and friends do. I can't say that I'm completely cured now, but I've learned how to balance my life. I run early and only do one long run a week. I listen to my body and make sure I have enough energy for my four year old. And, I still have rockin' times on trail marathons (I usually place in the top three of women). My husband and I were talking about affairs and I told him that I would never cheat on him. He said, "Uh, you already have with your ED and your running." That broke my heart. Just food for thought.

I know that moving a family across continents is quite expensive. We’re some that do it though, thinking it’s a worthwhile investment. Maybe your mental/physiological health is a worthwhile investment too?(I know that being a Dane I’m too used to have Mother State providing security to qualify for this discussion, but still)

And on the issue of employers.

Yes, reading about a possibly instable past will put some off.Just as seeing my cool purple hearing aids will put some employers off.

Hello from Rude Skov

Photo by Stine Sophie Winckel

...

My name is Tracy. I am a physician scientist from the USA, living with my husband and two young boys in Denmark. I work as a post-doc fellow at Næstved Hospital. I have a scientific interest in vision loss, vision loss during exercise, exercise, running during pregnancy, MAF training as well as nutrition and health for athletes. I also have a love for music, physics, statistics, cycling, yoga, cross-country skiing, bla bla bal.

I was a member of Team USA at the IAU World Championships in Ultra Trail Running in 2013 in Wales. I am now training to run with Team Denmark at the IAU World Championships in Annency, France in May 2015.